UConn Health Quality Improvement Efforts Making a Difference

UConn Health has recently received high marks for quality care in several key areas – and what happens behind the scenes to maintain and improve quality is equally as impressive.

Ann Marie Capo

Ensuring that patients consistently receive excellent care is an ongoing process, explains Ann Marie Capo, associate vice president for clinical effectiveness and patient safety and chief quality and patient safety officer. “We are on a journey to high reliability,” she says. “Customer service is a reflection of quality. For example, something as simple as asking patients how well their pain is being managed is a reflection of quality of care.”

The improvement efforts are making a difference. UConn Health has been named Top Performer on Key Quality Measures® by The Joint Commission, the leading accreditor of health care organizations in the U.S. UConn Health was recognized for exemplary performance in using evidence-based clinical processes that are shown to improve care for certain conditions.

Other Quality Ratings

UConn Health has not had a single central line infection for more than one year.

For 2012, the hospital achieved the prestigious American Heart Association Get With the Guidelines Gold award for heart failure treatment.

In the past year ending September 2012, the rate of being readmitted within 30 days for patients who had a heart attack or those with congestive heart failure is significantly better than the state average.

In that same time period, 100 percent of patients with community-acquired pneumonia (patients not needing the Intensive Care Unit) received the antibiotic indicated by guidelines, which exceeds both the state and national averages.

John Dempsey Hospital is the only hospital in the state to meet the required 48-hour deadline to get newborns’ blood samples to a laboratory for genetic testing, according to Connecticut’s Dept. of Public Health.

These clinical processes focus on care for heart attack, pneumonia, surgery, children’s asthma, stroke and venous thromboembolism, inpatient psychiatric services, and immunization for pneumonia and influenza. The ratings were based on data reports to The Joint Commission during the 2012 calendar year. Only one-third of all Joint Commission-accredited hospitals in the country achieved this recognition.

According to the unbiased Healthcare Association of New York State (HANYS), The Joint Commission’s ratings are considered the most valuable because the commission does not profit from their reports. Some other accrediting agencies require hospitals to purchase licensing fees to advertise their scores or sell business tools to hospitals to help improve their rankings.

Making strides

Capo acknowledges that even with recent successes, there is still work to do. “We have made enormous strides here, and we are committed to providing the best health care experience for our patients,” she points out. “This drives our performance improvement and how we become highly reliable as an institution.”

Dr. Frank Torti, executive vice president for health affairs and dean of the School of Medicine, agrees. “We want the excellence of our medical capabilities and research to be equally matched by excellence in our quality of care,” he says. “We are striving for excellence in key areas where the science of medicine is moving and where we could have an impact.”

As part of a statewide initiative toward high reliability, educators at UConn Health have also developed a training video featuring tools and techniques related to patient safety. “This video has been viewed by the medical staff as well as all of the more than 650 interns and residents in UConn’s training programs, and it’s available for use by all Connecticut hospitals,” says Dr. Scott Allen, medical director of clinical effectiveness and patient safety and assistant dean for John Dempsey Hospital.

“Huddling” for safety

Each weekday, behind the scenes, a “safety huddle” is held at the UConn Health, where dozens of staff members present brief reports from various departments, including diagnostic imaging, pharmacy, dietary, rehabilitation services, respiratory therapy, medical/surgical, maternal/child nursing, and many others.

They discuss quality-related issues such as improving the time it takes to transition patients from the Emergency Department to other care areas within the hospital; ways to prevent latex supplies from being used for patients with a latex allergy; ensuring equipment is used before its expiration date; confirming bed availability in areas throughout the hospital, and much more.

The meetings are swift, efficient and invaluable. Capo explains that much emphasis is placed on clearly documenting the care that UConn Health provides. “We know how important it is to put each data element into the record of care,” she says. “It’s the key to understanding how to care for patients and how to learn from any mistakes.”

Each weekday a “safety huddle” is held at UConn Health where dozens of staff members present brief reports from various departments. (Carolyn Pennington/UConn Health Photo)

Advances such as electronic medical records have gone a long way toward enhancing patient safety, she says, because “now we don’t miss things that we otherwise might have missed in handwritten records.” Other improvements have come in areas such as how well prepared patients are upon discharge, which “consistently has been our highest area” as measured by the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey, the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.

Quality and safety comes into play in many areas, including the construction now in progress at UConn Health with the building of the outpatient pavilion, a new hospital tower, and the planned expansion of the medical and dental schools. “We have to ensure that our buildings are constructed in a particular manner to avoid infection, that sinks are placed where they need to be, that a proper filtration system is in place – steps like that so that we do not cause harm to patients,” Capo points out.

Adverse events

Recently, hospitals throughout Connecticut began sharing information with one another about “adverse events,” which are events that either harmed or could have harmed patients and compromised their care. These include patient falls, medication errors, poor communication, and equipment failures.

“We look at best practices within our organizations and across the country,” Capo explains. “Human error happens, but we are pursuing a collaborative approach to eliminating them. Collective knowledge helps all of us make changes more quickly and efficiently.”